{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:34:12Z","timestamp":1787070852351,"version":"build-2736575974"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Letrozole is an effective ovulation-inducing agent for women with Polycystic Ovary Syndrome (PCOS), but its efficacy may be influenced by obesity. This study examines obesity\u2019s impact on letrozole-induced ovulation in infertile women with PCOS.<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n \n A prospective cohort study was conducted at a tertiary medical center in North India with 80 anovulatory women with PCOS. Participants received letrozole (5 mg daily, days 2\u20136) for up to three cycles. Ovulation was monitored through transvaginal ultrasound, and human chorionic gonadotrophin (HCG) was administered when a dominant follicle reached \u2265 17 mm. The association between obesity and letrozole response was assessed, considering clinical, metabolic, and hormonal parameters. Categorical variables were analyzed using the Chi-square test, and continuous variables were compared via Student\u2019s\n t<\/jats:italic>\n -test. Logistic regression assessed the relationship between obesity and ovulation, adjusting for age, body mass index (BMI), and baseline antimullerian hormone (AMH).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Eighty participants were recruited in the study including 51 (63.75%) responders and 29 (36.25%) nonresponders. Higher BMI, elevated AMH, and increased testosterone levels were linked to a negative response to letrozole. Grade II obesity (BMI \u226530 kg\/m\u00b2) significantly reduced the likelihood of ovulation (adjusted OR 8.49, 95% CI 1.06-67.56,\n P<\/jats:italic>\n = 0.043). Elevated AMH (>16 ng\/mL) was also associated with poor response (adjusted OR 5.15, 95% CI 1.52-17.47,\n P<\/jats:italic>\n = 0.009).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Grade II obesity is an independent risk factor for poor response to letrozole ovulation induction in PCOS. Personalized treatment based on BMI may enhance success rates.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jehp.jehp_1946_24","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T16:01:37Z","timestamp":1761926497000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Grade II obesity is an independent predictor of poor response to ovulation induction with oral letrozole in infertile women with PCOS: A prospective cohort study from North India"],"prefix":"10.4103","volume":"14","author":[{"given":"Shanti","family":"Tholiya","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Kumari","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reeta","family":"Mahey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mani","family":"Kalaivani","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hem C.","family":"Sati","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Reproductive Biology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarthi K.","family":"Jayraj","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neena","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"R1-20251130","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.fertnstert.2008.06.035","article-title":"The androgen excess and PCOS society criteria for the polycystic ovary syndrome: The complete task force report","volume":"91","author":"Azziz","year":"2009","journal-title":"Fertil 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